Matthew Adam Eisenberg, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00033811 Issued in WA

Practice address

315 Martin Luther King Jr Way
Mailstop 315-C5-Ads
Tacoma, WA 98405-4234

Phone

(253) 403-7307

NPI assigned

Oct 27, 2006

Last updated

Jun 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Hospital & Regional Medical Center 2

  • Children's Hospital
  • Seattle, WA
  • NPI 1083789630
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1184700627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13894 SE 64TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980064810",
            "telephone_number": "253-320-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "address_2": "MAILSTOP 315-C5-ADS",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-403-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "MATTHEW",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00033811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8194136",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John David Ehrhart, MD
• Brian Michael Eichinger, MD
• Richard Dean Eidal, DDS
• Kristen Alyse Eisenberg, FNP-C, ACNP-AG
• Lisa Eisenberg, OTR/L
• Seth Eisenberg, MD
• Jade Lynn Eitel
• Karen Eitniear, BCBA, LBA
• Kenneth Ejiogu, MD
• Julian Emeka Eke, PTA

• Pediatrics Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.